Dickdarmschädigung durch Chemotherapie und Bestrahlung

Damage to the colon can occur due to chemotherapy-induced mucositis, chemotherapy-induced diarrhea, chemotherapy-induced colitis or irradiation. For the former, a differentiation is made between neutropenic/necrotizing and ischemic (non-neutropenic) enterocolitis as well as immune checkpoint inhibitor colitis. The reasons for this are patient-dependent and treatment-related factors as well as the chemotherapeutic agents used or immunotherapies. In the differential diagnostics cancerous diseases themselves can also be the cause of diarrhea. These include carcinoid syndrome in neuroendocrine tumors (NET), lymphoma, Zollinger-Ellison syndrome, pheochromocytoma and also Clostridium difficile infections or postoperative diarrhea in short bowel syndrome. The medical history, physical examination, stool and laboratory diagnostics as well as imaging procedures are necessary for the rapid diagnosis and further treatment measures. Irradiation damage of the colon encompasses acute radiation proctitis and chronic radiation damage, which includes radiation-associated vascular ectasia (RAVE) and chronic radiation proctopathy.